Prior Authorization Specialist

Summary

Join Infinx as a dynamic and rapidly expanding company dedicated to providing innovative technology solutions and services tailored to our clients' needs. We are in search of experienced associates and partners who exude confidence and possess expertise in areas aligned with our clients' requirements.

Requirements

• High School Diploma or GED as a basic qualification
• 1+ year working in an office setting. Healthcare office or facility experience preferred
• Familiarity with medical terminology, especially in Oncology
• Strong teamwork capabilities, self-motivation, and reliability
• Basic computer literacy

Responsibilities

• Obtain timely prior authorization or pre-determinations from all insurances, to include commercial plans, Medicaid, Medicaid and Medicare Advantage plans, following the company's established policies and protocols
• Selecting accurate and pertinent medical records from patients' charts from client's EMR
• Obtaining demographic information and verifying insurance information
• Provide all required clinical information to insurance companies necessary to facilitate the authorization process
• Perform complete documentation (within company software or client's EMR) on all prior authorizations follow-ups and determinations appropriately and in a timely manner
• Maintain and update internal listing of insurance carriers that require authorization, their processes, and phone and fax numbers
• Maintain the strictest confidentiality in accordance with HIPAA regulations and clinic requirements

Benefits

• Access to a 401(k) Retirement Savings Plan
• Comprehensive Medical, Dental, and Vision Coverage
• Paid Time Off
• Paid Holidays
• Additional benefits, including Pet Care Coverage, Employee Assistance Program (EAP), and discounted services